Q In critically ill patients on mechanical ventilation, is a semirecumbent position of 45° feasible and effective for prevention
of ventilator associated pneumonia (VAP)?

METHODS

Design:

randomised controlled trial.

Allocation:

concealed.

Blinding:

blinded (outcome assessors).

Follow up period:

median 5–6 days (range 0–64 d).

Setting:

4 intensive care units (ICUs) in 3 university hospitals in the Netherlands.

Patients:

221 adults (mean age 64 y, 63% men) who were intubated within 24 hours of ICU admission and had an expected duration of ventilation
⩾48 hours.

Intervention:

semirecumbent position (backrest 45° from horizontal) (n = 112) or supine position (10°) (n = 109) for the duration of ventilation.
A nurse adjusted the backrest of the bed to the allocated position 2–3 times daily, but it could be changed at patient request
or as required for care.